The holidays can be a joyful time, offering a chance to reconnect with friends and family. They can also be stressful and hectic. You may feel pressure to buy and give gifts, have concerns about money, or feel like there isn’t enough time to get everything done.

Think about the kinds of events that trigger stress for you during the holidays. Then, you can focus on one or two things you can do that will help the most to reduce stress.

Here are some ideas:

Preparing for the holidays 

1. Know your spending limit. Lack of money is one of the biggest causes of stress during the holiday season. This year, set a budget, and don’t spend more than you’ve planned. It’s okay to tell your child that a certain toy costs too much. Don’t buy gifts that you’ll spend the rest of the year trying to pay off.
2. Give something personal. You can show love and caring with any gift that is meaningful and personal. It doesn’t have to cost a lot. Or, use words instead of an expensive gift to let people know how important they are to you. Make a phone call or write a note and share your feelings.
3. Get organized. Make lists or use an appointment book to keep track of tasks to do and events to attend.
4. Share the tasks. You don’t have to do everything yourself. Share your “to do” list with others. Spend time with friends and family while you share tasks like decorating, wrapping gifts, and preparing the holiday meal.
5. Learn to say no. It’s okay to say “no” to events that aren’t important to you. This will give you more time to say “yes” to events that you do want to attend.
6. Be realistic. Try not to put pressure on yourself to create the perfect holiday for your family. Focus instead on the traditions that make holidays special for you. And remember that just because it’s a holiday, family problems don’t go away. If you have a hard time being around your relatives, it’s okay to set limits on your time at events.

During the holidays

You may not be able to avoid stressful situations during the holidays, but you can plan to respond to them in a healthy way.

1. Take breaks from group activities. Pay attention to your own needs and feelings. Spend a little time by yourself if you can. Meditate, or do some relaxation breathing. Go for a short walk.
2. Keep a regular sleep, meal, and exercise schedule. Limit your alcohol. Taking care of yourself will help you deal with stressful situations during the holidays.
3. Get support if you need it. Holidays can sometimes trigger depression. They can be especially hard if you are already dealing with the death of a loved one or the breakup of a relationship. You may feel embarrassed to ask for help, or you may think that you’ll get over “the blues” on your own. But most people need treatment to get better. Talk with your doctor about counseling and medicine for depression.

Help is available. For additional information, visit MagellanHealth.com/MYMH

By Sam Srivastava and Mostafa Kamal

This week, the federal government took a significant step forward in helping address the opioid epidemic with the signing of the nation’s first comprehensive opioid legislation.

The Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act addresses a broad range of Medicare, Medicaid, public health and law -enforcement issues and aims to advance the recovery landscape for individuals living with opioid use disorder (OUD) and other substance use disorders (SUDs).

As longstanding advocates for access to mental health and substance use disorder treatment and services, we’re deeply appreciative of the bicameral, bipartisan work of the Congress to successfully drive this critical effort forward. The legislation contains a number of impactful policies we at Magellan Health, and many others, have pushed for, including those recommended in our testimony to Congress this past spring. These critical policies promote clinically appropriate opioid prescribing, support opioid misuse prevention, and enhance access to evidence-based treatment and recovery services.

The signing of this law marks a significant milestone and step in the right direction, and we believe there are several ways it has the potential to address some of the day-to-day challenges of the nation’s opioid epidemic. Three key areas stand out.

Safer prescribing patterns. The SUPPORT for Patients and Communities Act encourages the use of safe and effective alternatives to opioids for pain management, which – in addition to clinically appropriate prescribing practices – are key in breaking the cycle of prescription opioid misuse. These include the establishment of grant programs incentivizing the use of non-pharmacological opioid alternatives, the required implementation of safety limits for opioid prescriptions, new electronic prescribing requirements in Medicare, and beneficiary screening requirements in initial Medicare prevention exams, to name a few.

Our experience demonstrates the power of these and other safe-prescribing interventions—such as the Centers for Disease Control and Prevention’s prescribing guidelines, which Magellan has already implemented—to reduce opioid misuse rates.

Americans consume 80 percent of all opioid painkillers produced worldwide—and the risk of addiction after just four or five days of treatment is high. Opioid prescribing rates have decreased in recent years thanks to nationwide efforts to ramp up provider education. Yet the supply of prescription opioids remains high – approximately 66.5 opioid prescriptions for every 100 Americans in 2016 – reflecting the work still needing to be done.

By exploring alternative therapies to pain management, including non-pharmacological digital therapies, we can eliminate the risk of opioid misuse and addiction, and also equip individuals living with chronic pain with the tools and resources needed to live healthier, more vibrant lives.

Boosted access to evidence-based treatment. One of the most effective, evidence-based treatments for OUD is medication-assisted treatment (MAT)—considered the gold standard for reducing the risk of overdose and death. When combined with psychosocial interventions, like cognitive behavioral therapy and contingency management, and recovery supports, including peer and family, MAT empowers the recovery journey while building resiliency.

Increasing access to MAT is critical to promoting recovery and preventing relapse. Today, while 900,000 U.S. physicians prescribe opioids, fewer than 35,000 physicians are certified to prescribe buprenorphine, one of three medications approved to treat opioid addiction.  Even fewer of these actually participate in prescribing MAT and, as a result, access to care is often limited or stigmatized. The SUPPORT for Patients and Communities Act expands providers’ ability to prescribe MAT, including by expanding eligibility for certification to new provider types. With stigma also playing a role in the lack of widespread adoption of MAT, this provision is a solid and necessary step toward expanding access to treatment.

Reaching underserved communities. The SUPPORT for Patients and Communities Act facilitates telehealth options for OUD treatment. In communities with limited resources for one-on-one OUD recovery support, telehealth services or a combination of virtual and in-office services provide the basis for the most evidence-based, person-centered and well-rounded approach to treatment. The package also authorizes pilot programs to provide temporary housing services for individuals recovering from OUD. We believe this is crucial to supporting those living with OUD and other SUDs, especially in rural and underserved communities, return to healthy and vibrant lives.

 The SUPPORT for Patients and Communities Act provides practical policy solutions necessary for addressing this national crisis. From expanded treatment options, to more effective care coordination, to improved prescription drug monitoring programs used to enhance detection and prevention of opioid misuse in real time, this legislation is an important step in the right direction.

We applaud Congress and the Administration on this bipartisan effort and important law, which will have a deep and lasting impact on health for generations to come.

 About the authors:

Sam Srivastava is Chief Executive Officer of Magellan Healthcare, and Mostafa Kamal is Chief Executive Officer of Magellan Rx Management.

Senior Whole Health, a wholly-owned subsidiary of Magellan Health, has a core mission of addressing the social and medical needs of individuals eligible for Medicare and Medicaid, with a special focus on putting services in place to allow elderly individuals to remain safely in their homes for as long as possible.

The average Senior Whole Health member is 76, female, has several chronic illnesses, and takes five or more medications. In spite of the fact that many members have home-based community services and regular nursing visits, a majority of the admissions for hospital and emergency department care are unexpected. While it is not feasible for all high-risk members to have a daily evaluation by a clinician, Senior Whole Health is implementing a program of passive home monitoring for select high-risk members allowing for early detection of changes in behavior that identify when an individual is at risk for hospitalization. With prompt interventions by clinical staff, trips to the Emergency Department and/or Hospital can be averted.

The program being used by Senior Whole Health is called Lively® Home, a GreatCall product offering. With advance permission of the member and their family, a suite of 10 passive sensors is installed in the home. Activities of daily living such as getting into and out of bed, using the toilet and opening the refrigerator are monitored, allowing for a normal pattern of activity for an individual to be modeled. In the event that the individual’s behavior pattern changes (such as staying in bed much longer than usual or using the refrigerator much less than usual), an alert is sent to clinical staff, allowing for a wellness call to the member to check on their status. Often a medical condition can be identified and treated in the outpatient setting, avoiding more serious outcomes including hospitalizations and/or premature nursing home admissions.

Seniors have listed losing independence as among their greatest fears of aging. The use of passive monitoring technology such as Lively® Home along with direct in-person support services is expected to further extend the ability of high-risk Magellan Health members to live safely and independently as long as possible at home.

Family members can play an important role in helping a loved one with co-occurring mental health and substance use disorders get on the road to recovery. Support a loved one’s recovery by:

• Helping a loved one remember to take all prescribed medications for one or both disorders
• Listening to any concerns about medications – such as their purpose, benefits, and side effects – and helping address those concerns
• Making sure appointments with treatment providers are kept
• Working with the treatment team to stay informed and help address any issues related to medication

To learn more, visit Mind Your Mental Health.

Source: Behavioral Health Evolution

There is no mistaking that opioid addiction is a major social issue in the United States but there is also a lot of confusion and misinformation. We’ve included seven frequently asked questions about opioid addiction below.

1) What are opioid medications?

Opioids are medications prescribed to relieve physical pain. Opioid medications bind to the areas of the brain that control pain and emotions, driving up levels of the feel-good hormone dopamine in the brain’s reward areas, and producing intense feelings of euphoria. As the brain becomes used to the feelings, it often takes more and more of the drug to produce the same levels of pain relief and well-being, leading to dangerously high tolerance levels, dependence, and later, addiction.

2) What are the names of some common opioid medications?

• Codeine

• Fentanyl citrate

• Hydrocodone (e.g., Vicodin)

• Hydromorphone (e.g., Dilaudid)

• Mepedridine (e.g., Demerol)

• Morphine (e.g., Kadian, Avinza)

• Oxycodone (e.g., OxyContin, Percocet)

3) What are opioid medications used for?

Opioids are used to treat moderate to severe pain that may not respond well to other pain medications. They provide relief from an array of symptoms associated with respiratory illnesses, severe coughing, injuries, trauma, surgery, dental procedures and chronic pain.

4) How do people become addicted?

Taken as prescribed, opioids can be used to manage pain safely and effectively. However, since these drugs also affect the brain regions involved in reward, some people experience a euphoric response. Those who abuse opioids may seek to intensify their experience by taking the drug in ways other than those prescribed.

5) What is the difference between opioid dependence and opioid addiction?

Physical dependence on opioids means that the body relies on an external source of opioids to prevent withdrawal. Normally the body is able to produce enough endogenous opioids (i.e., endorphins) to prevent withdrawal. However, as tolerance increases over time, eventually the body’s ability to maintain its equilibrium is exceeded and the body becomes dependent on the outside source of opioids. Physical dependence is predictable, easily managed with medication, and is ultimately resolved with a slow tapering off of the opioid.

Unlike physical dependence, addiction is a change in behavior caused by biochemical changes to the brain after continued substance abuse and it is classified as a disease. Addiction takes the form of uncontrollable cravings, the inability to control drug use, compulsive drug use, and continued use despite doing harm to oneself or others. Strong cravings are common to all addictions. These cravings are rooted in altered brain biology. Recovery is the process of reversing, to the extent possible, these brain changes. This is accomplished through therapy and replacing the addictive behaviors with healthy alternative behaviors.

6)  What are the signs of an opioid addiction?

• Constricted pupils

• Nausea

• Itchiness

• Drowsiness

• Reduced social interaction

• Anxiety

• Poor memory and concentration

• Slowed breathing, movement and reactions

• Mood swings

• Apathy and depression

7) What does treatment involve?

Opioid addiction is a chronic disease, like diabetes, asthma and hypertension. While it can’t be cured, it can be treated to help the person regain a healthy, productive life. Treatment programs typically include detoxification, medication for opioid withdrawal, counseling and the support of family and friends. The goal of the treatment program is to help the person get through the withdrawal successfully and learn new coping skills to address addictive behaviors over the long-term.

Additional Resources

Centers for Disease Control and Prevention (CDC)

The CDC website features a section devoted to opioid information, data and FAQs. In addition, there are guidelines for prescribing opioids for chronic pain to help ensure patients have access to safer treatment options.

National Institute on Drug Abuse (NIDA)

NIDA provides information odrugabuse.govn commonly abused drugs, the latest science and treatments, trends and statistics to improve individual and public health.

The American Society of Addiction Medicine

A society of physicians aimed at increasing access to addiction treatment. They offer a nationwide directory of addiction medicine professionals.

The Substance Abuse and Mental Health Services Administration (SAMHSA) or 1-800-662-HELP

Find locations for residential, outpatient, and hospital inpatient treatment programs for drug addiction and alcoholism throughout the country.

The Partnership at Drugfree.org or 1-855-378-4373

Provides information and resources on teen drug use and addiction for parents to help them prevent and intervene in their children’s drug use or find treatment for a child who needs it.

Help is available. For additional information, visit MagellanHealth.com/MYMH

Read more about opioid addiction here.

1. Those who abuse prescription opioids are 40% more likely to use heroin than those who don’t.
2. The United States consumes 80% of the world’s prescription painkiller supply, despite not even making up 5% of the world’s population.
3. It’s possible to die the first time you use cocaine, consumption quadruples the risk of sudden death.
4. An estimated 88,000 people die per year due to alcohol.
5. Only about 11% of those addicted to drugs or alcohol actually receive treatment for their substance abuse disorder.

Source: Drugabuse.com

October marks National Breast Cancer Awareness Month, which focuses on increasing awareness and highlights the importance of early detection. Breast Cancer is the leading cause of cancer-related death in women with 40,000 deaths related to breast cancer in 2016. However, millions of women are surviving and thriving with breast cancer when found and treated early.

Magellan Health is a proud supporter of National Breast Cancer Awareness Month.  Help spread the importance of conducting monthly breast self-exams and the powerful impact early detection can have on a woman’s life.

Learn more about the importance of early detection and how to conduct a self-exam.

Source: Surveillance, Epidemiology, and End Results (SEER) Program. Accessed July 14, 2017

On the 10^th anniversary of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA), the Association for Behavioral Health and Wellness (ABHW), the national voice for payers that manage behavioral health insurance benefits for over 175 million people, and its member companies today declared continued support for, and further commitment to, creating parity in behavioral health treatment and coverage.

While MHPAEA was signed into law on Oct. 3, 2008, ABHW and its member companies’ efforts to address mental health and substance use disorder (MH/SUD) parity have a much longer history – decades. As an original member and Chair of the Coalition for Fairness in Mental Illness Coverage (Fairness Coalition), we worked with a diverse coalition of stakeholders to win equitable coverage of MH/SUD treatment, and were an avid advocate and supporter of the final bill that became law.

Mental health and substance use disorder parity is a right. Everyone deserves access to equitable, affordable, medically appropriate, high quality mental health and addiction services and treatment. ABHW member companies have diligently worked to drive consistent interpretation and enforcement of MHPAEA across the United States. We will continue our efforts through:

• Improved access to behavioral health treatment, services, and providers;
• Behavioral health co-payments that align with medical visit co-pays;
• Elimination of arbitrary treatment limitations on the number of days of coverage for a condition, as well as financial limits on annual and lifetime dollar caps;
• Adjustments to prior authorization requirements for mental health and substance use disorder services so that they are comparable to medical benefits; and
• Integration of medical, pharmacy, and behavioral health benefits to increase consumer engagement and reduce overall medical costs.

While great strides have been achieved, we acknowledge that more can be done to ensure that mental health and addiction parity is being implemented in the manner in which it was intended.

• Accreditation – Currently there is no parity accreditation standard that would deem a health plan parity compliant. Recognition of such an accreditation by consumers, federal and state governments, employers, and providers would support consistency of interpretation and assessment of parity compliance.
• Best Practice Examples – Additional illustrations from the federal regulatory agencies of health plans that are implementing MHPAEA correctly or states that are accurately enforcing MHPAEA would be very helpful in advancing parity compliance. If regulating agencies release de-identified information related to non-compliance issues it would provide interested parties with a thorough picture of the regulator’s intent related to MHPAEA and would lead to improved compliance.
• Substance Use Disorder – Currently, there is not parity in the way health care professionals access SUD records. This puts SUD patients at greater risk and inhibits integrated care for these individuals. Since SUD patients and their records are siloed from the rest of medicine, many individuals are receiving substandard, uncoordinated care.

ABHW and its member companies are committed to the full implementation and enforcement of the parity law. We will continue our efforts to work with consumers, employers, health plans, state Medicaid agencies, regulators, legislators, providers, behavioral health interest groups, and others to further parity compliance, educate consumers about the law, and provide the tools and resources needed to make informed decisions.

Signed,

Association for Behavioral Health and Wellness

Aetna Behavioral Health

Anthem

Beacon Health Options

Centene Corporation

Cigna

Magellan Health

New Directions Behavioral Health

Optum

PerformCare
ABHW is the leading health plan association working to improve access and quality of care for mental health and substance use disorders. ABHW’s members include national and regional health plans who care for more than 175 million people. Together we work to reduce stigma and advance federal policy on mental health and addiction care. Member companies – Aetna Behavioral Health, Anthem, Beacon Health Options, Centene Corporation, Cigna, Magellan Health, New Directions Behavioral Health, Optum, and PerformCare.